“You don’t have what I would call true mental illness.”

This is a sentence that was said to me during an inpatient admission last year and it’s a conversation I have thought long and hard about and I feel it is vital to post about because there are myths and stigma within the mental healthcare system and personally I find that quite shocking. If anyone should understand, surely it should be those who work in the sector?

At the time I was detained under Section 2 of the Mental Health Act. I was on level 3 observations which is where a nurse or healthcare support worker is with the patient at all times, also called ‘within eyesight’. Usually they sit on a chair in the patient’s doorway. So the healthcare support worker (unqualified) who was sat with me at this time said to me that I didn’t have what he would call true mental illness because I could hold a conversation. I was outraged, I was poorly enough to be legally held in a hospital, and to be watched constantly, of course I had ‘true’ mental illness. Yes, I could hold a conversation but what does that have to do with my mental illness? I was struggling with anorexia nervosa, low mood and suicidal feelings. It was a sentence that simply makes no sense, if I think back to my last admission all of the patients could hold a conversation. I would understand if this comment came from someone with no experience but this is someone working on a psychiatric ward.

There are many myths that exist within services and I think they are a lot of the reason why young people in particular are often not given the help they need. Another common one is, “but you’re well dressed.” It takes me 5 minutes to throw my clothes on and throw my hair up in a messy bun but unfortunately (or fortunately) being a 22 year old my wardrobe is full of Topshop, ASOS, New look and Primark clothes and my wardrobe does not suddenly empty and re-fill with ‘mental’ clothes because my mental health takes a nasty turn. Nearly every urgent psychiatric assessment I have had they have used the way I am dressed to basically say that I am fine when I have been so poorly. It didn’t matter if I had worn those clothes for an entire week, they would still tell me I’m well dressed.

I almost feel that when it comes to getting help from mental health services that there is a ‘young persons curse’ because my skin is youthful and my clothes fashionable and I can hold a conversation about the modern day because you know what I wasn’t born in the 60s or the 70s or the 80s so no I can’t be stuck in the past! It’s their ticket to say that the patient is fine, looks fine, will be fine when really it’s the polar opposite.

“You have capacity” is a sentence they used in the weeks running up to my recent detention under Section 2 of The Mental Health Act. This is when the thoughts were constant, everything I looked at was telling me how to die, I had the thought to hurt myself on everything I saw, everything I walked past, everything I thought about. I was screaming at them that I didn’t want to hurt my family, I didn’t want to ruin their lives and all they were telling me was that I had capacity, that it was all my choice! How did I have capacity? I could focus on or remember anything that was going on around me, I couldn’t think of anything else but dying but regardless of capacity I was unwell and unsafe and needed help.

There is a lot of stigma around mental illness, a lot of words unspoken and many myths floating around but if they need to be dissolved from anywhere, they definitely need to be dissolved from mental healthcare services.

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12 thoughts on ““You don’t have what I would call true mental illness.”

  1. whoever this healthcare provider is, they should be reported. At least they can open the DSM and see that “holding a conversation” and “dressing nice” are not criteria listed on any of the 947 pages…

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  2. Claire, that is so awful. I don’t know how I would cope if I ever had people doubting my illness like that. Easier said than done but PLEASE don’t let their ignorance influence your recovery. You will get there, lovely and we need you to be healthy and strong so that you can help make the changes that so obviously need to happen. Thinking of you xxx

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  3. Do you think given how inappropriate these kind of subjective assessments are there is a way of challenging it as a legitimate measure of assessment at mental health assessment encounters?

    You can’t make these kind of subjective comments in most bother areas of healthcare, they went out with the ark, why are MH providers still doing this?

    What can be done.

    My absolute best get up and go out might equal your = threw on something and washed face by virtue of overall looks and genetics!

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  4. I constantly hear comments along the lines of ‘youre too well dressed/well presented/articulate to be unwell.’ By far the worst stigma I have received has been from mental health professionals, rather than from family, friends or in the workplace. It infuriates me, and leaves me feeling powerless as it seems to be a way of blocking access to necessary support and treatment. I’ve pointed out how unprofessional and inappropriate it is, but nothing seems to change! Gah! Awful that it seems to happen to so many.

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  5. This is truly infuriating. A psychiatrist, who happens to be the head psychiatric consultant in the area where I live and is head of the local psych ward, listened to my mental health history, looked me up and down and said ‘Seriously? But you’re… nice!’

    When mental health professionals assume that articulate and well dressed people are exempt from mental illnesses there is a serious problem!

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    1. I’m so sorry to hear that happened to you, it is so wrong. Mental health professionals should know better than anyone that mental illness doesn’t stereotype, anyone can be unwell. I hope you are now being listened to and helped xxxx

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